Learning disabilities have occurred infamously successful people –
Walt Disney, Alexander Graham Bell, and Winston Churchill all had learning
disabilities. In the U.S., 15% of the population has some sort of a learning
disorder. That’s 1 in 7, according to the National Institutes on
Health. Eighty percent of those labeled Learning Disabled (LD) have problems
with reading and language skills. Being a successful LD person in life
takes some navigation through government red tape and a willingness to
get beyond considerable marketing hype. Let’s get down to it.
According to the Federal Special Education Law (Individuals with Disabilities Education Act IDEA) passed in 2004, a learning disorder is
“A disorder in one or more of the basic psychological processes involved
in understanding or in using language, spoken or written, which disorder
may manifest itself in the imperfect ability to listen, think, speak,
read, write, spell, or do mathematical calculations. Such term includes
such conditions as perceptual disabilities, brain injury, minimal brain
dysfunction, dyslexia, and developmental aphasia. Such term does not include
a learning problem that is primarily the result of visual, hearing, or
motor disabilities, of mental retardation, of emotional disturbance, or
of environmental, cultural, or economic disadvantage.”
The National Joint Committee on Learning Disabilities has a further
refinement of the definition:
“Learning disabilities is a general term that refers to a heterogeneous
group of disorders manifested by significant difficulties in the acquisition
and use of listening, speaking, reading, writing, reasoning, or mathematical
skills. These disorders are intrinsic to the individual, presumed to be
due to central nervous system dysfunction, and may occur across the life
span. Problems in self-regulatory behaviors, social perception, and social
interaction may exist with learning disabilities but do not, by themselves,
constitute a learning disability. Although learning disabilities may occur
concomitantly with other disabilities (e.g., sensory impairment, mental
retardation, serious emotional disturbance), or with extrinsic influences
(such as cultural differences, insufficient or inappropriate instruction),
they are not the result of those conditions or influences.”
Both these definitions include the concept that learning information is
simply more difficult for these individuals, because of various information-processing
dysfunctions in the central nervous system.
But the definitions do not include many of the elements that can make up
a learning disability. For example, the definitions exclude organ abnormalities
– e.g. blindness or deafness. The definitions do not include emotional
disturbance and mental retardation. They do not distinguish between a
processing or perceptual abnormality – how accurately I
feelsomething, and a behavioral abnormality – whether I am simply too
tired, or too angry, or too oppositional to put out the effort required
to learn something. The definitions also ignore that nutrition, allergies,
and environmental toxins can contribute to learning disabilities.
Whenever there is too much sensory/intellectual/emotional input, we tend
to function at a lower level than normal. If we have learning disabilities,
with perceptual and processing difficulties, we become dysfunctional much
more rapidly than people who do not have LD. These dysfunctions express
themselves in different ways, not necessarily related to learning. Some
of us cover our ears and cower down. Some of us get angry and/or frustrated.
Some of us cry. Some of us scream. Some of us beat our spouses. Some of
us beat ourselves. Some of us just give up trying. Some of us become physically
ill in one way or another.
Insurance Companies Dictate with Codes
Diagnosis and treatment is further complicated by the insurance industry.
Each of the specific learning disabilities has a specific ICD-9 code by
which an insurance company may identify the specific diagnosis. Which
code your doctor uses may mean the difference between insurance coverage
and no insurance coverage for the condition. For some peculiar reason,
insurance companies often seem to feel that developmental delays should
not be covered, since they might repair themselves spontaneously some
day. As critics have pointed out, insurance companies make every effort
not to pay out claims. Here’s a look behind the scenes of the insurance
codes doctors can use:
- 784.60 covers both dyslexia and alexia (inability to read at all). This
is the definition of the International Dyslexia Association: “difficulties
with accurate and / or fluent word recognition and by poor spelling and
decoding abilities. These difficulties typically result from a deficit
in the phonological component of language that is often unexpected in
relation to other cognitive abilities and the provision of effective classroom
instruction. Secondary consequences may include problems in reading comprehension
and reduced reading experience that can impede growth of vocabulary and
- 315.02 is the code for developmental dyslexia.
- 784.69 covers Acalculia, Agnosia, Agraphia NOS, Apraxia.
- 315.2 if for Dyscalculia – occurs where a person has trouble solving
arithmetic problems and grasping math concepts.
- Dysgraphia – use the ICD-9 code for agraphia, 784.69 – occurs
when a person struggles to form letters or write within a defined space
Auditory and visual processing disorders occur when a person with normal
hearing and vision nevertheless has difficulty understanding and using
verbal or written language.
- 315.32 is the code for central auditory processing disorder – this
is also the code for “mixed receptive-expressive language disorder”
- 388.45 is the code for an acquired auditory processing disorder
- Non-verbal learning disabilities are defined as “specific disorders
which originate in the right hemisphere of the brain and cause problems
with visual-spatial, intuitive, organizational, evaluative and holistic
processing functions. There is a V code, V40.0, problems with learning.
784.6 is a general code that covers “other symbolic dysfunction”.
It is easy to be denied insurance coverage because one digit is wrong.
Parents can more readily get a diagnosis and insurance coverage for ADD
than they can for LD, yet “the system” is unclear about the
differences, or if there is a difference between the two.
Learning Disabilities Versus ADHD
It is estimated that 7% of children aged 4 to 17 are affected with LD,
and an equal number are affected with ADHD. Note: Attention Deficit
Disorder (ADD) is not quite the same as Attention Deficit Hyperactivity
Disorder (ADHD), but the two are usually lumped together in the statistics.
More importantly, ADHD and LD are often found in the same child.
LD tends to run in families, so heredity may play a role. Some cases of
LD can be traced to brain development, both before and after birth, so
low birth weight, lack of oxygen, premature birth, and early nutrition
may be a factor in learning disabilities. Infants and young children are
susceptible to environmental toxins. Lead and mercury are linked to learning
ADD is also a broad category covering different things – attention,
activity, and impulsivity. As is the case with learning disabilities,
ADD may have a genetic link, may be related to birthing issues, nutrition,
and environmental toxins.
In both cases, there is an issue with brain chemicals called neurotransmitters.
These chemicals help send messages between nerve cells in the brain.
What can you do for your child?
In some classrooms, 100% of students are on medication for some form of
learning or attentional disorder. Medication is associated with increased
risk of heart disease and sudden death, even in children. Doing nothing
is associated with increased dropout rates, and poor functioning in society.
According to California neurologist Dr. Fred Baughman, “The single,
biggest heath care fraud in U.S. history – the representation of
attention deficit hyperactivity disorder (ADHD) to be an actual disease,
and the drugging of millions of entirely normal American children as “treatment,”
is spreading like a plague – still. Once children are labeled with
ADHD, they are no longer treated as normal. Once methylphenidate hydrochloride,
or any psychiatric drug, courses through their brain and body, they are,
for the first time, physically, neurologically, and biologically abnormal.”
Are children with ADHD and/or LD really broken? Do they actually have a
disease treatable with drugs? Are they capable of learning in some way
without any further pharmaceutical or behavioral intervention?
Increasingly, parents want a drug-free solution. At the Arizona Center
for Advanced Medicine, we look for what is causing the problem, and we
take a holistic view.
First, we distinguish between the child who simply has difficulty learning
because he sees letters reversed and the child who has difficulty learning
because he does not see the letters at all – either because his
visual pathways are impaired, or because he is not looking where the letters are.
Then we look at nutrition, since a starving brain has an extremely difficult
time simply functioning, much less learning anything. We often think of
the brain as a computer that just has to be plugged in to an electric
outlet in order to work perfectly. However, if the software is deficient
or corrupted, the computer sits there on the desk, but does not run your
programs very well. Similarly, the brain functions through electrical
impulses and specific pathways. However, in order to generate those impulses,
it requires many nutrients – proteins to supply the amino acids
needed for manufacture of neurotransmitters and other messengers, glucose
to supply the energy needed for the manufacturing process, lots of vitamins
and minerals to serve as co-factors, or assistants, in the manufacturing
process… And the pathways have to be correctly developed, and able
to handle the flow of information. If any of these components are missing
or deficient, then the brain can no longer process information at top
speed. It slows down, or gets the messages garbled.
We also look at
food sensitivities and allergies – some specific foods can cause a child to become agitated, to space
out, or to become violent. In our office we have seen well-behaved children
suddenly start to bite their mothers, hit their siblings, wander around
in a daze – all when they are tested for specific foods. Sometimes
what sets the kids off are not foods, but rather colorings, additives,
and preservatives. Red dye #40 is a big culprit, for example. The symptoms
are readily reversible, when the appropriate dilution of the substance
is administered, and the effects are reproducible.
We look at the child’s environment – identifying anything in
the environment which might be toxic to them. For example, sometimes a
child will react to mold in the classroom, or have a bad day every time
the grass is cut because of allergies to the grass. Some children react
to pesticides or to chemical air “fresheners.”
We also look at brain processing of all the sensory modalities –
touch, hearing, and vision appear to be the most significantly affected.
Some children cannot abide having tags in their clothes, and always have
to have the tags cut out before they will wear the garment. Some children
cannot stand to be touched, because they find that light touch is painful
– but they are perfectly OK with being hugged very hard, or wrapped
in a blanket. Some children cover their ears when they go into an echoing
mall – or simply have a melt-down. Conventional medicine has no
treatment for these behaviors except sedating drugs. We actually use specific
sensory exercises and music therapies to restore the normal functioning
of the sensory nerves which clearly were dysfunctional.
We enable the brain to make more connections, and with the treatment we
let it know where to make the new connections. We can restore function
to the starving brain, and enable the children finally to catch up in
school, and to learn information as easily as their peers. They may require
some tutoring to catch up, but at least now they have the ability to do
the work – they just have to learn the mechanics, like all their peers.